| dc.description.abstract | Abstract Aims To assess the role of myo-inositol in women with polycystic ovary syndrome (PCOS) and to understand the views and attitudes of stakeholders towards a definitive trial to compare myo-inositol on its own and as an adjunct to letrozole: ❖ To assess the evidence on non-pharmacological interventions in women with PCOS. ❖ To assess the role of inositols in women with PCOS. ❖ To establish the safety of letrozole as a fertility drug. ❖ To assess stakeholder’s views in designing a future trial to assess role of myo-inositol. Methods ❖ Systematic review of reviews to evaluate the existing systematic reviews on non-pharmacological interventions. ❖ Systematic review of effectiveness of inositols. ❖ Systematic review of potential harmful events associated with letrozole. ❖ Survey of stakeholders: gynaecologists and consumers. Results ❖ There is lack of evidence of benefit with lifestyle intentions on reproductive outcomes, with some potential benefits with inositol. ❖ Inositols significantly improve ovulation rate, metabolic and hormonal profile in women with PCOS, with gaps in evidence on pregnancy and live birth rate. ❖ Letrozole is not associated with increased risk of congenital malformations when compared with other fertility agents. 13 ❖ Two third (72%; 58/81) of the gynaecologists and majority (90%;130/144) of the consumers are willing to participate in a future trial evaluating role of myo-inositol for ovulation induction in women with PCOS. Conclusion Further methodologically rigorous and adequately powered primary studies for the non-pharmacological interventions, including myo-inositol in women with PCOS are needed. The lack of evidence of harm to the fetus, should enable international bodies to reconsider the classification category of letrozole as a fertility agent and facilitate its routine clinical use. Gynaecologists and consumers agree for the need of further studies to explore role of myo-inositol in women with PCOS and are willing to participate in such trial. | en_US |
